Evaluation of Cardiovascular Disease in Patients with Diabetes Mellitus Using Myocardial Perfusion SPECT / 임상당뇨병

ABSTRACT

The number of patients with diabetes mellitus increases every year. Compared with the nondiabetic population, diabetic patients have an increased risk of developing cardiovascular disease and an increased risk for death from myocardial infarction or congestive heart failure. In diabetic patients, compared with people without diabetes, coronary artery disease is often silent, more advanced at diagnosis, and associated with an unfavorable prognosis. To maximize the effect of appropriate treatment, it is important to stratify patients according to their risk of future clinical events as early as possible. Commonly used noninvasive tests in coronary artery disease include exercise ECG, stress echocardiography, coronary CT and MRI, and stress myocardial perfusion SPECT. The generally used radioisotopes for myocardial perfusion SPECT are 201Tl and technetium-based agents such as 99mTc-MIBI and 99mTc-tetrofosmin. Stress myocardial perfusion SPECT provides information on perfusion and function including wall motion, ejection fraction, and myocardial viability. Also, the hemodynamic significance of coronary artery stenosis can be assessed. Stress myocardial perfusion SPECT provides quantifiable data and identifies patients with diabetes who are at low and high risk for future adverse cardiovascular events. These risk stratification data are useful in planning appropriate treatment strategies for patients with diabetes.